Dale's Review Concepts II Flashcards
1
Q
___ = Unicellular organism that harm the body by producing endotoxins & exotoxins
A
Bacteria
2
Q
____ = obligate intracellular parasites
A
Viruses
3
Q
Endotoxins VS exotoxin
A
Endotoxins = poisonous/harmful stuff in bacterial cell wall = inflammation, sepsis, etc.
Exotoxin = poisonous/harmful stuff is Ed bacteria, when released outside = cause damage
4
Q
What are pyrogens?
A
Messengers released from WBCs that tell hypothalamus to make fever
5
Q
Name the 5 P’s for assessing an Arterial Occlusion
A
Pain Pulseless Pale Parenthesia Paralysis
6
Q
What is Claudication?
A
Cramping pn (usually in calves) gets worse w/ exercises, goes away w/ rest DT ischemia from Clot
7
Q
_____ = a group of mental disorders = reality distortion, social withdrawal, disturbed thoughts/emotions/perception.
A
Schizophrenia
8
Q
You have a psych pt you suspect is schizophrenic. At what age does this disorder usually start
A
Early adulthood
9
Q
What’s Boyles law?
A
- think: Boyle = bottle. A small O2 bottle really high pressure. Big bottle does not*
Boyles law = volume gas inverse to it’s pressure
10
Q
What’s Dalton’s Law
A
*Think: Dalton… ALL IN 100%”
Dalton’s law = sum of ALL partial pressures IN a gas = 100%
11
Q
What’s Henry’s law
A
- think: Henry = Tennessee. They drink coke in Tennessee. Co2 in a coke can bubbles to top of coke can”
Henry’s law = concentration of gas in liquid = partial pressure of gas above liquid
12
Q
What’s Charles law?
A
- Think: Charlie and the Chocolate factory. Wonka rides an air balloon. Air expands w/ heat.*
Charle’s law = vol. of gas expands w/ heat (gets smaller w/ cold)
13
Q
What is prinzmetal Angina?
A
Angina that happens DT coronary artery vasospasm. From stress, exercise, hyperventilation, cold weather.
14
Q
Pt fell asleep outside in winter, currently has CC: numb foot that appears yellow, white w/ mottled blue spots. What is wrong? What RX?
A
Frost bite.
Rx = splint, dry loose dressing, no let pt use it/stand on it, don’t rewarm it unless MCP tells you too.
15
Q
Frost nip vs Frost bite
A
Frost nip = mild form, numb/tingling, easily reversible
Frostbite = full ischemic injury DT frozen tissue
16
Q
Superficial vs Deep frost Bite
A
Superficial = Underlying tissue remains soft (numb burning tingling)
Deep = yeah. Yellow/white/mottled blue, numb = gangrene later
17
Q
Trench foot vs frost bite
A
Trench foot same as frost bite but DT long cool/wet exposure. Can happen @ higher temps like 60F
18
Q
Pt has itchy red/purple lesions on body after prolonged cold exposure. What is it?
A
Chilblains
19
Q
What conditions & meds make a pt more susceptible to hypothermia?
A
Hypothyroidism Hypoglycemia Immobile Over aggressive Heatstroke Rx Any med that vasodilates
20
Q
How do trauma pts lose a lot of heat?
A
Direct contact w/ ground/pavement
21
Q
Typical SS of hypothermia
A
Stumble, mumble, fumble, grumble
22
Q
What temp range is mild hypothermia and what SS?
What Rx?
A
95-90F (35-32)
All the umbles (stumble, mumble, grumble, fumble)
Rx = passive warming (blankets + heater)
23
Q
What temp range is moderate hypothermia? What SS?
What Rx
A
90-82F (32-28)
Pt shivering stops
Osborn waves @ 90F
Rx: Active external warming
24
Q
What temp range is severe hypothermia?
What Rx
A
75-68F (24-20)
Rx = warm fluids
25
Hypothermia can be confused with what other emergencies?
CVA, TBI, ETOH, psych
26
How would you Rx a hypothermic cardiac arrest differently from a normal one?
No vaso pressures until pt at 86F (check local protocol)
27
True or false: rough handling of a hypothermic pt can cause vfib.
False. No evidence of this
28
You must always resuscitate a hypothermic cardiac arrest pt. What are exceptions to this?
Submersion in water >1 hr (unless icy)
CBT < 50F
Frozen so stiff, compressions not possible
29
What is a toxidrome?
Groups of poisonings that have the similar/predictable SS
30
What are the 5 toxidromes
```
Narcotic
Sympathomimetic
Sedative-hypnotic
Cholinergic
Anticholinergic
```
31
Pt has Resp depression, pinpoint pupils, Brady, sleepy/coma, IV tracks. What toxidrome?
Narcotic
32
Pt has fight/flight SS, hyperthermic, paranoia, HTN, seizures, cardiac dysrhythmias. What toxidrome?
Sympathomimetic
33
Pt has respiratory depression, sleepy, w/ normal pupils. What toxidrome?
Sedative-hypnotic. Only narcotics will make pinpoint pupils
34
Pt has DUMBELS or SLUDGEM SS. What toxidrome
Organophosphate
35
Pt is red, dry, hyperthermic, and altered/delirious. What toxidrome?
Anticholinergic.
Think “red as a beat, dry as a bone, hot as a hare, mad as a hatter”
36
What drug class: stimulants
Sympathomimetic s (uppers)
37
What drug class is marijuana
Sympathomimetic
38
What drug class is ETOH
CNS depressant
39
How can you tell if someone OD on a barbiturate or benzo?
Similar to alcohol/Drunk SS
40
Classic SS of a cyanide poisoning
Smell of almonds
41
Rape drugs are what class of drugs?
Strong Benzos
42
How does hydrofluoric acid/ hydrogen fluoride affect the body? What Rx?
It leaches Cations from you = lethal & quick death
Rx = cations (Na, Ca, K)
43
What lethal dysrhythmia can a tricyclic antidepressant develop into? What is the Rx?
Rx = sodium bicarb
Tricyclic OD can = torsades. At this point, use mag sulfate
44
What is a salicylate? How does an OD affect the body?
Salicylate = analgesic like aspirin.
OD = metabolic acidosis
45
Why cant you give aspirin to kids?
Reye’s syndrome = cerebral edema & liver failure
46
What happens when you OD on Tylenol (acetaminophen)?
NV = pn = metabolic acidosis & AKF
47
___ = fluid builds up in pericardial sac & compresses the heart, disrupting CO
Pericardial tamponade
48
You suspect a pt has pericardial tamponade. What SS to look for?
What Rx?
Beck’s triad:
JVD, muffled heart sounds, narrowing pulse pressure (early sign), hypotension
Rx =. Fluids PRN to maintain CO. Pt needs a pericardialcentesis
49
What’s Cauda Equine Syndrome?
Compression of nerve bundle @ end of spinal cord (L1) DT trauma, tumor, infection, herniation = neuro/bowel issues
50
Pt had recent MVC w/ Low back injury. Now has SS: low back pn, loss of sensation/motor function in legs, ACUTE BLADDER/BOWEL ISSUES. What’s wrong?
Cauda Equine Syndrome
51
What is autonomic dysreflexia?
Parasympathetic NS doesn’t work below spine injury = sympathetic overdrive
52
Pt had a spinal cord injury above T4-T6. After some time, pt now has SS: HTN, seizure, Brady, chills w/ no fever, blurred vision, dilated pupils, dysrhythmias. What’s wrong?
Autonomic Dysreflexia. His sympathetic NS is in overdrive
53
Explain the “nail in Back” (Brown-Sequard syndrome_
Partial damage to spinal cord DT penetrating trauma or ischemia (lesion/tumor/clot) = SS to involved side
54
Pt has ipsilateral motor loss & contralateral pn/temp sensation below the site of a spinal injury. What’s wrong?
Brown-Sequard syndrome
55
What is HONK/HHS ?
Hyperosmolar nonketotic coma = hyperglycemia (>600 mg/dL) for DM type II
56
What is DKA?
Diabetic ketoacidosis = hyperglycemia (>350/400 mg/dL) for DM type I
57
HONK vs DKA
Both are hyperglycemia. HONK is for type II, DKA for type I.
In HONK, there is still insulin & glucose = no ketones in blood
DKA = no insulin = ketones & acidosis
58
Pt takes amaryl & metformin and had a recent infection. Now has SS: altered, hypotensive, dry warm skin. What’s wrong? What Rx?
Pt has DM Type II (ex. Metformin) & got an infection which spiked his BGL into HONK. He’s now severely dehydrated as a result.
Rx = secure airway & aggressive fluid resuscitation (500ml bolus)
59
Type I vs Type II DM
Type I = congenital or after 30. Autoimmune response destroys beta cells = no insulin
Type II = Hyperglycemia DT insulin resistance from poor lifestyle
60
Pt has polyuria, polydipsia, hypotension, AMS. No glucose in urine. What’s wrong?
Diabetes insipidus
61
What is diabetes insipidus?
Body can’t keep fluids DT lack of ADH or kidney issue = dehydration, electrolyte imbalance
62
Useless growth in body from cellular mutation (cancer of brain/spinal cord). What is it?
A neoplasm
63
New onset seizure in middle age/older adults. Serious or no?
Serious. Could indicate brain tumor. All new onset seizures need a CT scan
64
Ottitis Media vs Externa
Otitis Media = inner ear infection
Otitis Externa = outer ear infection
65
Pt has itchy painful ear after day at the beach. You check and its inflamed and red inside. What’s wrong?
Otitis Externa
66
Pt has vertigo fever, ear pn w/ dizziness. What’s wrong?
Ottitis media
67
Why do kids get more inner ear infections than adults (ottitis media)?
Kid Eustachian tubes more horizontal than vertical = poor draining = higher infection risk.
68
Why can ottitis media (inner ear infection) be serious?
It’s often linked to brain abscesses
69
Number one sign of Renal Calculi (kidney stones)?
Number one way to prevent them?
Hematuria
Prevention = hydration!
70
Pt has intense radiating flank pn, hematuria, pale diaphoretic. What’s wrong?
Kidney stones (renal calculi)
71
Following a boxing match, pt has curtain coming down over their vision & sees floaters/specks. What’s wrong?
Detached Retina
72
Pt has sudden painless vision loss in one eye. What’s wrong?
Central Artery Occlusion (pt has a clot in their eye)
73
What is hyphema?
Bleeding in anterior chamber of eye DT blunt trauma
74
Pt has photophobia, pn, blurred vision following blunt trauma to their eye. You notice the bottom half of pupil filled w/ blood. What’s wrong?
Hypema
75
Pt has a sunken in stomach (scaphoid belly), unequal lung sounds, and heart sounds in an an unusual spot. What’s wrong?
Diaphragmatic Hernia
76
On which side of the body does a diaphragmatic Hernia usually happen?
The L side. Liver usually covers all of the R side
77
What NS is fight or flight?
Sympathetic
78
What is the neurotransmitter of the sympathetic NS
Norepinephrine
79
What are the receptor sites of the Sympathetic NS? What do they each do?
```
A1 = vasoconstriction
A2 = vasodilate
B1 = Heart (ino/chromo/dromotropic)
B2 = bronchodilator
B3 = shiver & vagina stuff
```
80
What NS is “rest/repose, feed/breed”
The parasympathetic NS
81
What is the neurotransmitter of the parasympathetic NS?
Acetylcholine
82
What are the receptor sites of the parasympathetic NS?
Muscarinic & Nicotinic
83
Pt has sudden back & abdominal pn/tenderness w/ shock SS. You suspect possible AAA. What other SS will confirm this?
Pt has need to bear down.
Pulsating mass on abdomen
84
Pt has unbearable tearing chest pain that radiates back between shoulder blades. You BP and notice one arm has a higher BP than the other (20mmHg difference) whats wrong?
Thoracic aneurysm
85
What are the 3 layers of the heart?
What is the inside opening called?
From inner most to outer most…. Tunica intima, tunica media, tunica Adventitia.
Inside opening = lumen
86
Normal P wave length
< 0.12s
87
Normal PRI
0.12 - 0.20s
88
Normal QRS
0.6 - 0.11s
89
Normal QT interval
< 1/2 preceding R-R interval or 0.30-0.45s
90
How many seconds is a small box on an ECG? A big Box?
Small = 0.04s
Big = 0.20s
91
How long are the marks at the bottom of an ECG strip?
3s
92
Subdural vs epidural hematoma
Both you get knocked out and regain consciousness…
Subdural = slowly deteriorate (venous bleed)
Epidural = rapid deterioration (arterial bleed)
93
Pt has flu SS w/ CP worsened by productive cough. Sputum is greenish w/ streaks of blood. Pt is dehydrated. What’s wrong?
Pneumonia
94
What kind of ppl easily get pneumonia?
Immune compromised
Smokers
Chronic illness pts
People w/ ventilatory compromise (bedridden, asthma, COPD, sedentary)
95
Pt has sudden weight loss, cough >3 wks, fever, hemoptysis, and night sweats. What’s wrong? What BSI?
TB
Use surgical mask & air ventilations in tract
96
What placed people usually have TB?
Homeless, poor, long term care facilities
97
What’s a Bruit?
Abnormal whooshing sound auscultated over vessel = turbulent flow (atherosclerotic disease)
98
How long does it take food to go from mouth to anus
8-72 hours
99
What’s peristalsis?
Smooth muscle contractions to move food through GI
100
In the stomach, food gets converted to ____
Chyme
101
Food exits the stomach via the ____ into the duodenum
Pyloric valve
102
What vessels take nutrients from the small intestines to the liver?
The Portal veins
103
What does the hypothalamus do?
Links endocrine & nervous system
Body functions & emotions
104
What does the pituitary gland do?
Secrete hormones to control all other glands
105
What does the Thyroid gland do?
Regulate metabolism and calcium levels
106
#1 cause of renal calculi?
Hypercalcemia
107
What does the thymus gland do?
Immune system: matures T cell lymphocytes
108
What is unique about the thymus gland compared to others?
It goes away by your 20s. T cell lymphocytes live long, so it is not needed anymore
109
Why does the pancreas have a dual function: exocrine & endocrine?
Exocrine = secretes digestive enzymes for protein break down
Endocrine = alpha, beta, delta cells make glucagon, insulin, Somatostatin (respectively)
110
What are the two parts of the adrenal hormones?
Cortex & medulla (inside cortex)
*think “medulla - middle”
111
What hormones from adrenal cortex?
Aldosterone = Na + water retention
Cortisol = blood glucose maintenance
112
What hormones does the Adrenal Medulla secrete
Epi & norepi
113
What are androgens?
All male hormones (ex. Testosterone)
114
What hormones do the ovaries secrete?
Estrogen = sex development
Progesterone = Prepares uterus for pregancy/periods
some testosterone
115
Briefly explain the inflammatory process, starting w/ “vessels…”
- Vessels constrict, then dilate & get permeable
- Fluids leak through = swelling
- Mast Cells release histamine
116
What’s another name for WBCs
Lymphocytes
117
What are 3 functions of the lymphatic system
- Fluid balance
- Circulates WBCs (lymphocytes)
- Nutrient/hormone transport
118
Where is the thymus & what does it do?
between upper sternum & aorta
- Matures T cells & lymphocytes
119
where is your spleen & what does it do?
LUQ
Filters blood
120
___ = outside, visible part of the ear
The Pinna
121
___ = aka “ear drum”
Tympanic membrane
122
What inner ear structure controls balance & looks like a sea shell
Semicircular canals/ Cochlea
123
__ = aka “ear wax”
Cerumen
124
What instrument is used to examine ear canal
Otoscope
125
Best laryngoscope blade for a pediatric and why?
A miller blade (the straight one). Allows for better control of kids’ bigger tongues
126
What is the narrowest part of a pediatric trachea? (During intubation)
The cricoid ring (under the glottis/vocal cords)
127
Cranial nerve I (name & function)
Olfactory Nerve = Sensory reception & smell
*imagine: olFACTORY = A SINGLE (one) perfume factory (smell)*
128
Cranial nerve II (name & function)
II = Optic nerve = sight
*think: you need TWO (II) eyes to SEE (vision)*
129
Cranial Nerve III (name and function)
III = oculomotor = eye/eyelid movement & pupil size
* think: Three (syllables) = OC - CU - LO*
130
Cranial nerve IV (name and function)
IV = Trochlear = downward/inward eye movement
*think: look DOWN INto the TRUNK (sounds like Troch)* FOR (IV) stuff*
131
Cranial nerve V (name and function)
V = Trigeminal = jaw/chewing & touch sense in face/scalp/teeth/cornea
* think… The GEMINI (trigeminal) killed FIVE (V) people and ripped their FACES (pain location) off*
132
Cranial nerve VI (name and function)
VI = abducens = lateral eye movement
*6(VI) virgins were ABDUCted (Abudcens) during the lateral eye movement*
133
Cranial nerve VII (name and function)
VII = facial nerve = expressions, secretions, blinking, taste
*think: what does your face DO?”
134
Cranial Nerve VIII (name and function)
VIII = vestibulocochlear = hearing/balance sense
*think: Vestibule + cochlea are in the ears*
135
Cranial nerve IX (name and function)
IX = Glossopharyngeal = swallow, salivate, taste
* think pharyngeal = Pharynx (tongue stuff)*
136
Cranial nerve X (name and Function)
X = Vagus = swallow, pharynx/epiglottis, Parasympathetic NS
*think Vagus = VEGAS. Drink until your heart stops (brady)*
137
Cranial nerve XI (name & function)
XI = Accessory = SHoulder/head movement
*Think accessories go on your head & shoulders*
138
Cranial nerve XII (name & function)
XII = hypoglossal = tongue movement
*think = lick your lips (tongue) to make them glossy.*
139
What is the BP equation
BP = CO x SVR
140
What’s the equation for cardiac output
CO = SV x HR
141
What’s the equation for MAP?
MAP = DBP + 1/3 (SBP -DBP)
142
What’s the formula for Stroke Volume
SV = preload x contractility mediated by afterload (AKA SVR)
143
What is the pediatric BP formula
SBP = 70 + ( 2 x age)
144
Pt w/ recent child birth complains of lower ab pain, foul discharge, fever, NV. What’s wrong?
Endometritis
145
What is Endometritis? Who gets it?
Inflammation of endometrium DT bacteria common after birth or miscarriage
146
Pt has heavy long periods, pn during sex, rectal pressure, and constant deep pn @ low back/ab/pelvis. What’s wrong?
Endometriosis
147
What is Endometriosis. What is a main complication.
Tissue identical to endometrium grows outside uterus = ectopic pregnancy risk
148
What organ controls your breathing? How?
medulla reads CO2 and pH in CSF
Pons controls breathing rhythm
149
What structures are located in the brain stem
Midbrain, pons, medulla oblongata
150
What does the midbrain do
- Eye reflex/movement,
- coordinated motor activity
- brain-spinal cord message relay
151
What does the pons do?
Relays signals up/down, breathing, sleep cycle
152
What does the Medulla oblongata do?
all VS & respirations
153
What chemoreceptors are in the Medulla?
CO2 & pH of CSF
154
What chemoreceptors are in the carotid & Aortic bodies
Po2, Pco2, pH
155
What are baroreceptors? Where are they?
Detect BP changes in aortic arch, carotid sinus, kidneys
